The Role of Estrogen Receptor, Progesterone Receptor and p53 in Development of Stress Urinary Incontinence

Abstract

Recent studies have been reported the roles of the estrogen receptor (ER), progesterone receptor (PR) and p53 in the development of a pelvic organ prolapse (POP). The pathogenesis of stress urinary incontinence (SUI) is related to that of POP in the weakness of pelvic support. Therefore, this study was carried out to assess the relationship between ER, PR, p53 and the development of SUI, and to elucidate the biomolecular pathophysiology of SUI. The periurethral fascia was obtained from 6 menopausal patients diagnosed with SUI and 10 menopausal patients without SUI who visited the Department of Obstetrics and Gynecology, Severance Hospital, Seoul, Korea. The relative ER, PR and p53 protein levels in the periurethral fascia were obtained by western blot analysis and densitometry. A Mann-Whitney U test was used for statistical analysis (p < 0.05). The mean age (±SD) of the 16 patients was 59.0 ± 5.5 years (range, 50-74 years). The mean body mass index was 25.2 ± 2.7 kg/m2 (21.8 - 30.8) and the average number of vaginal deliveries was 2.8 ±1.9 (1.0 - 9.0). The ER level (0.33 ± 0.17 vs. 1.86 ± 0.83, p=0.02) and the p53 level (1.25 ± 0.67 vs. 4.71 ± 2.40, p=0.01) were lower in the experimental group. However, the PR level of the two groups were similar (0.64 ±0.13 vs. 0.48 ± 0.33, p=0.56). The p53 and ER levels were significant lower in the study group. This suggests that p53 and ER might be important factors in the development of SUI. Further prospective studies about the association of ER, p53 and SUI will be needed to elucidate the molecular pathogenesis of SUI.